Focal Fatty Infiltration

📄 SCRS

Hepatic
Focal Fatty Infiltration

Hepatic Focal Fatty Infiltration ultrasound case study

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Reporting Panel

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Liver Pathology

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USG

Hepatic Focal Fatty Infiltration ultrasound case study

CASE–1

Clinical History

Patient was referred for abdominal ultrasound due to abnormal liver function tests or incidentally detected focal hepatic echogenicity on previous imaging. There is no known history of hepatic mass lesion or chronic liver disease.

Ultrasound Findings

Ultrasound examination demonstrates a well-defined focal hyperechoic area within the liver parenchyma, commonly located adjacent to the falciform ligament, gallbladder fossa, or porta hepatis. The lesion shows geographic or wedge-shaped margins without mass effect. Normal hepatic vessels course through the involved area without displacement. No internal calcification, cystic change, or increased vascularity is demonstrated on color Doppler imaging. The remaining liver parenchyma may show diffuse fatty infiltration or appear otherwise normal.

Report Line

A focal geographic hyperechoic area is seen within the hepatic parenchyma, measuring approximately ____ × ____ mm. The area shows no mass effect, with normal intrahepatic vessels traversing through it without displacement. No internal calcification, cystic change, or increased vascularity is seen on color Doppler imaging. Findings are suggestive of hepatic focal fatty infiltration.

Impression

Features are consistent with hepatic focal fatty infiltration, a benign hepatic pseudolesion. No sonographic evidence of a true focal hepatic mass lesion.

Key Learning Points

• Focal fatty infiltration is a benign pseudolesion and should not be mistaken for a hepatic tumor.
• Common locations include the gallbladder fossa, falciform ligament, and porta hepatis.
• Lesions are typically geographic or wedge-shaped with no mass effect.
• Normal portal and hepatic veins traverse the affected area without displacement.
• Color Doppler demonstrates normal vascular architecture without abnormal internal vascularity.
• Important differential diagnoses include focal fatty sparing, hemangioma, hepatocellular carcinoma, metastasis, focal nodular hyperplasia, and hepatic adenoma.
• Correlation with CT or MRI may be considered when sonographic findings are atypical.

Recommendation

Clinical and laboratory correlation is recommended. In patients with typical ultrasound features, no specific treatment is required. When imaging characteristics are atypical or clinical suspicion persists, contrast-enhanced CT or MRI may be performed to exclude a true focal hepatic lesion.